Losing my job!

Im with the same employer (nhs) over 20 years. Ive been on sick leave this past year. Had my Occ Health app yesterday and she asked how I was, told her still some fatigue, soreness as Im off my aza this past week & hope to restart it next week. My white cells are dropping all the time this past few months on aza so getting weekly bloods done for this. Anyway I said i would like to return to work hooefully end of dec but she said no you are not fit enough yet & my bloods & activity level need to be well stable for a few weeks consistently? I argued with her that I will feel ready in another 5 wks and she was having none of it. HR is now holding meeting with me to basically dismiss due to ill health. Im so let down as I feel that just when I am ready to come back Im told goodbye? Any words of comfort or advice 😞 How can Occ Health make thst decision surely they need harder evidence?

27 Replies

  • That is so unfair, and considering you work FOR the NHS, twice the blow. I'm so sorry. (The NHS is the UK's healthcare system, right? I'm an American and thiiiink that's the name for it?) I lost my job recently, too, while in the hospital, while sick, BECAUSE I was sick, and it was crushing. You'd think after 20 years of service they'd be willing to cut you a break.

    I'm so sorry this is happening to you. You deserve better. *hugs*

  • Thanks. Lupus is so unfair. I had really geared myself up for going back, i just feel so let down.

  • I am so sorry to hear about this, I to work for NHS have been for 15 years and like you I have had a year off when I was first diagnosed with lupus. Went back to work and work for nearly 11months and then got hit by a massive flare and have been off for 4 weeks and hopefully want to go back next week. I'm not so scared having read your post as I have a meeting with OH as well. That has always been my biggest worry of being told to leave due to ill health even though you feel well. I had to book annual leave just so I could attend my hospital appointment.

    I agree it is so unfair, we did not want this, all I can say is if you are with the union speak to them, all the best, take care xxxx

  • Thanks for your reply. I was diagnosed 6 years ago and have spent time in hosp etc with complications from lupus. I managed to keep working although i had alot of sick leave. Since i went off with a PE last year my health just has not been good. I tried & failed returning to work in May was back 8 wks and off again. Work were willing to have me back now but i made the mistake abd said to occ health bloods were low but this is side effect of aza. For this reason she wouldnt sign me fit yet & HR are taking the view of dismissal based on that as occ health says it would be another few weeks before im ready.

  • Thanks ajanjua good luck for your return to work x

  • What are Occ Health's qualifications? Is your GP or Consultant offering them advice? Do you have a union rep? I'd try suggesting to HR that they could need some specialist knowledge of your current health and prognosis befored dismissal. Try mentioning the Disability Discrimination Act. It may be that they should at the least be offering adjustments and a phased return to work before considering dismissal on these grounds.

    If the worst comes to the worst, make sure you get every penny of your pension rights in terms of early retirement due to ill health.

    And a big hug from me x

  • I know you won't want to hear what I am going to say. I don't know what Shann does but:

    Occy Health in the NHS is staffed by doctors who coordinate their work with the patient's doctors when they are not specialists in the particular illness - and in my experience they will fall over backwards on the side of the patient. There are two sides to the story of the sick employee and the employer, and the NHS is a particular case.

    Depending on what you do, it may be impossible to get in agency staff to cover your sickness periods. Agency staff - as you will know from the media - cost the NHS a LOT of money and they are being told they shouldn't be doing it. A department is responsible for paying at least some of your sick pay as well as the cost of the agency person - a double whammy for them out of their budget. They cannot advertise your post until they know you are leaving - not even on a temporary basis because they cannot say how long a contract would be.

    I'm sure you have all been in the position of being told your appointment has been cancelled/delayed or you have had to wait months for a procedure/scan - and very often that is because someone has called in sick, short or long term. On the wards, there may be a bank nurse who knows the ward in question and who can pull their full weight with the tasks. In other departments, the person who is sick may be the only person who is doing that particular procedure in that particular hospital. No-one else can just turn up at short notice and fill in as for many posts, training takes up to 6 months. So tests can't be scheduled until they know the person in question will be back and not possibly be off sick again after a few weeks.

    As far as I am aware, in the NHS you still get up to 6 months off sick at full pay depending on how long you have been working. Then you get a period at half pay plus statutory sick pay. My daughter has had time off because of a work injury and for asthma which is exacerbated by the infections she catches from patients - and after a relatively short time, she was on a list, knowing if she had any further sick leave she would face a disciplinary hearing. She could have 6 months off in one fell swoop with less to worry about than having a week with asthma a couple of times plus an injury.

    It isn't as simple as you might think - but they will have looked at it from all sides. There are a lot of hoops to jump through in the NHS before they get to the stage of terminating your contract - it took my husband 2 years to be able to replace a member of staff who was off sick on a semi-permanent basis, they returned to work and within weeks were off again. Which meant the colleagues were doing 50% extra to cover - which put them under stress - which made them ill too and they would call in sick for a day or two.

  • Sorry, I replied before seeing your other answer, but I still think HR needs more than Occ Health for this.

  • Hi, thats what i was thinking. I probably waffled on a bit to OH as Im just so used to rhyming off issues with bloods etc - didnt think it was reason to say unfit as with lupus bloods are always up & down due to meds etc. She asked if i exercise & i said not much - do they forget i have lupus & excercising is not always possible, i shouldve said I did go walking though so mad at myself. Maybe i should say to my gp who actually knows my whole history & see would she give me a supporting letter? Afterall this OH dr dosent even know me or is not specialised in lupus. I was too honest about meds & bloods to occ Health i really didnt think she would say I couldnt return at end of dec as thats few wks away? Told her im currently off aza but hopefully starting again next week. Thanks for your advice x

  • PMRpro does have a point there. I worked in the DH, where, believe what you like about civil servants I was rather needed. I once gave policy advice from a hospital bed because I was the only one who knew the particular answer quickly. My boss was disciplined for going to such lengths - he should have had the grasp himself, but that is clearly different from any physical hands-on job.

  • I'm going through the exact same thing. First thing you MUST do is get union representation. Whether it is RCN or Unison, contact then now!

    The next thing you need to look into is applying for medical retirement. I know it sounds drastic but if occi health truly wont pass you as fit to return to work you can be dismissed on grounds of ill health but this is only after a hearing, your case for staying has to be heard. If you do get dismissed it will mean that you will be able to claim some level of benefit if you are dismissed as a result of ill health. They may try to terminate your contract but my understanding is that they can't do this if you consider medical retirement. There are different tiers of medical retirement and it sounds like you could potentially meet teir 1 category. If you are accepted for this you get access to your pension and can return to work at a later time if you are able.

    The key thing to remember is DO NOT RESIGN!!! I thought about resigning myself, you know like 'going out in a more dignified way' but if you do that you won't get anything.

    It's really crappy and tough and after two phased returns and one redeployment I am in the same position as you and I'm only 35!

    Get on the blower to your Rep and don't attend a meeting without them. Look up NHS medical retirement on google, lots of info there and if possible, daft as it may sound, try not to stress about it. It will only make your lupus worse.

    Good luck!

  • Hello Im so glad to hear from someone whi is in the same position even though its so sad you are going throught this too. Im 38 and work in admin in nhs its not a very physically demanding job. Occ Health are saying that in order to sustain a working pattern (18 hrs) i need my bloods & physical activity alot better & they cant predict when this will be even though i have said i would like to try to come back late Dec? Secondly, occ health dr says I dont qualify for ill health retirement as all treatment options for lupus hasnt been explored. So basically i get my contract finished & given 12 wks money after 20 years? I feel its outreagous they can do this & feel so demoralised as my line manager who never liked me will be at meeting gloating. My union is involved & very supportive, basically the plan with HR was for me to be signed as fit to return in few weeks but occ health said not yet. Trust taking the view they have waited long enough for me to get better & theyre now saying dismissal. I am worried finacially & how i will manage its just so horrendous on top of all my health problems feeling so sad. Do you mind me asking what your job is?

  • I'm a registered nurse with the RCN. My understanding is that it isn't down to occi health doctors whether you qualify for ill health retirement or not. My understanding is that you apply for it with the support of your union and a panel of external people, separate from your trust make that judgement. Please look up ill health retirement tier 1 catagory as I will be really surprised if you don't meet it. Exhausting all options for treatment applies to tier two. My understanding is tier one is basically that in the timeframe that you have had, your condition has not been able to be got under control but you may be able to return to wrk at a later time with further treatment. Please look up NHS Pensions Ill Health Retirement Factsheet. It may help.

  • Hi there, so sorry to hear about all that's going on with you. Its all very stressful especially when unwell, gentle hugs.

    My advice is make sure you know the sickness policy very well, it should be on the intranet or the NHS equivalent. Some policies, well now the norm really, do have disciplinary action for length of sickness absence or repeated absence which can lead to dismissal, quite legally.

    Did you see an OH doctor, if so what level, qualifications or did you see an OH advisor (nurse) and again did they have specialist qualifications?

    There should also be some guidance on the OH service, what you can expect and what to do if you have a complaint. OH services should be giving you a copy of the report or an agreed verbal outline for you to agree the report, as in if there are any errors, not necessarily agree with their professional opinion which they are duty bound to give.

    OH advice is just that advice, it is not legally binding on an employer although of course they would need a good reason to be ignoring it.

    If you are in a union, do contact them and ask that they are present at any meetings.

    The big question and I know its a tough one (having gone down this route myself and now not working ) is are you really ready to return to work in 5 weeks?

    If you are out of sickness absence from a policy point of view before this return to work date, can you return earlier on a phased return, eg a reduced number of days, reduced hours initially to get that return to work date brought forward. That would likely fall under reasonable adjustment. Some policies allow or require folk to use their holiday entitlement for this others don't allow it at all, so again check the policy.

    If you are not well enough to return to work within the timeframes, when are you likely to be fit, or as mentioned earlier are you likely to be unfit long term and eligible for ill health retirement. That has quite a high bar usually, again you would need to check the policy, but generally speaking it has to be reasonably likely that you would be permanently unfit in any capacity in any job, any hours even another employer before normal retirement age. (I didn't meet that one)

    Other possibilities are redeployment or permanent of reduction in hours again it depends on the policies and whats available at the time.

    I would have a really good chat with your GP about your health, and about what they feel is realistic in terms of returning to work.

    At the end of the day, though if you feel well enough and know you can, then go ahead and return, ask HR for a phased return and agree a date and hours over a 4-5 week period.

    Good luck x

  • Thank you so much for your brillant advice. This forum is just amazing such intelligent people on here lol! I think i will have a chat with my GP & explain the whole situation I have 2 posts & hope to keep on my 8 hr weekly post and probably resign from my substantive post. I just hope they give me that oppurtunity. My meeting is in 2-3 wks its such a dread waiting. X.

  • I worked for NHS so had to go through occupational health and sickness capability policy as I was having a lot of absence due to my Lupus ( and absence pre diagnosis). My line manager had to follow the capability proceedure but also in the final year of my sickness record being so erratic and severe he was virtually "forced" to consider me losing my job (otherwise it would have impacted on the service my dept provided, my manager may have even lost funding for my post etc, so I do understand it from their point of view also).

    As part of what I went through I finally got retirement due to ill health, but whist waiting for that decision also did get dismissed due to ill health. I was only 37

    here is a link to my experince about that lupusuk.org.uk/working-with...

    Lupus is a disability and covered under the equality act. Your employer has to try make "reasonable adjustments" to keep you in work. It could be that they consider they have already been "reasonable" but perhaps if you really do feel that you will improve to be able to get back to work and can get your Drs to support that, then they may have to give you another trial. The guides from Lupus UK may also be of use to you and your employer


    Firstly see your GP and discuss it all (also ask consultants advise if you have a consultant). You will have to honestly address wether you are well enough to work or not, and be realistic about wether NHS/your Dept can support you in any more ways.

    It can be hard to accept that you are not well enough to work, and in my experince it is a struggle to accept losing your job. In my experience I kept fighting how ill I really was I kept trying to return after sickness absence, kept trying to give medication chance to work etc. It actually made my Lupus worse by trying to work when really I was not accepting that I was not well enough. Also the whole process severly affected my mental health, so I would advise ask GP about mental health support as you go through all this

    Make sure your union rep is with you at all meetings, and get union rep to look into retirement due to ill health options if they really are getting to stage of dismissmal due to ill health. I think they would have to have a very good reason not to consider retirement due to ill health if they do go down route of making you lose your job

    If they say there is no ill-health retirement because all treatment options are not exhausted then perhaps you can try the .... well then to be "reasonable" you have to let me explore all treatment options.

    If you want ill-health retirement and the pension then you and Drs will have to start saying in very strong terms it is highly likely that you would be permanently unfit in any capacity in any job, any hours (even another employer) between now and normal retirement age.

    In my experince you probably would also have to go through an appeals proceedure to get the ill-health reirement, as for me even with support of my dept manager, HR, OH, and all my Drs, they denied my inital application (I think mainly because I was so young, and also there is a financial implication of getting the ill-health retirement granted)

  • Thanks for your so detailed reply. So many of you seem to have gone through this process. Did you develop depression duirng this time, i hope you overcame that, the whole process is so stressful, and yes your right i think i do have alot of difficulty accepting that im not fit enough. The thing is I have 2 admin posts in nhs, one is 18 hrs, the other is 6-8 hrs a week. I am hoping to keep on the 8 hour post and i am willing to resign from my 18 hr post if Im lucky enough to do this. I really hate given into this illness as Ive always battled through & work kept me focused & help me feel 'normal'. I miss that so much, the social side of it & being financially independent but i always knew the day would come when i had to admit work was no longer an option 😞 Have you found not working any better for you healthwise?

  • My mental health got really bad I developed symptoms of hypomania ( at one point it was so bad I got "sectioned" as I did not have the insight that my mental health was not normal ( I actually thought I felt "great and full of energy" because I was getting better and the treatment was working! )

    My hypomanic symptoms are possibly because I get psychosis due to Lupus/ possibly I have some "neurological" involvement as I also can often get "brain fog"/ lack concentration due to my lupus. It was also possibly was brought on by the "trauma" of diagnosis, fighting to keep working, worry about my fianances, worry I would lose my home, fighting to win my ill-health retirement appeal.

    I have also had some bouts of depression. Depression can be part of having Lupus. In my case I think the depression was due to all the stress about not being able to work, and accepting that I could not work. I no longer get depression but I can still sometimes get hypomanic symptoms

    As I have had some episodes of both depression and hypomania some Drs think I may be bipolar but I never had mental health problems prior to having Lupus, and if I do get depressed it does not last, does not require medication treatment, and I can usually "snap myself out of it" whereas someone I know who truely does have bipolar can not "snap out" of depressive episodes and needs medication as well as other mental health support such as councelling

    Mental health support can really help whilst you are going through all this (I wish I'd had some prior to getting so bad that I got sectioned!, and as I now have a mental health care plan that has really helped me in general cope with having Lupus, not working etc)

  • Yes not working has been one of the best things for me and my health. I get less flare ups. I can sleep as I need to (I can not do mornings and I always need 10-12 hours sleep to remain stable and to be able to function such as cooking, shopping on a regular basis)

    Not working also allows me to pace myself much better, and has ment I even get time and energy to do a small amount of gentle exercise which has actually helped me feel better and less fatigued

    I think you have to put your health first, and accept your limitations due to having Lupus. Sure I now have less money and I still miss work as I loved my career but hey ho I'm still here and considerd "mild and stable" with my SLE

    Good luck in your journey

  • Thanks fabwheelie for all your advice really appreciate it x.

  • Hi Shann

    So sorry you are going to have to leave your job due to your ill health!. It does seem all the more galling that you work for the NHS!. My advice is to contact Citizens Advice as they have employment advisors who will make sure you get all help you should. They have a good website too with links to other helpful organisations and help. they will also run a benefits check later on to see if you could claim anything and will help you fill the forms in!. Best of luck to you. I hope you are better soon and will be able to do something else later on. Azathioprine is a difficult drug if it affects your blood count. I had to come off it for those reasons. X

  • I can only reply with my experience of working for the NHS. Your employer cannot sack you well you are ill. You have medical evidence that you have conformed with treatment and made every effort to return when you are fit. However, your employer takes a risk returning you too early. I too felt I was being pushed out but I had to take my time. I spoke to my consultants explained my job and asked them to write reports to supply to occ health and hr. I eventually returned on a graded return over six months. It was exhausting. Far more than I realised it would be. If you are concerned think of a union or citizens advice for support and at least a second ear in a meeting. Unfortunately I had to accept I'll health retirement. It was the right decision for me. I did try to return but I had to accept they were not forcing me out I just could not be reliable. Good luck, think of your own health.

  • Hi thanks for your advice. I am only hoping to hold onto an 8 hr weekly post & im willing to resign from my substantive post (18 hrs). Do you think i should ask GP to support this, would that help dispute occ health's advice to HR? Occ health has advised it would be another couple of months before im ready but HR are saying Im off so long now they have to take action.

  • Hi Shann07

    I was dismissed Oct 3rd 2016 due to sickness and won my appeal and reinstated but i am also speaking with Barrister for disability decriminalisation as they need to medically retire you not sack you. Equality Act is what they need to be reminded of.

    Good luck

  • Thanks Paula. Im just hoping to still have the opportunity to return even to my 8 hr post. Glad you won your appeal it must have been stressful for you x.

  • Hi there,

    I am really sorry to hear that you are having these difficulties with your employer. We have two leaflets on lupus and work that you might find useful and that you can download or request from our website lupusuk.org.uk/wp-content/u... and lupusuk.org.uk/wp-content/u...

    You might also want to speak to your local Citizen Advice Bureau about your employment rights. Let us know how you get on.

  • Thanks for that. So much support on this forum its really comforting.

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